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Women's Health (London, England) 2023Women experiencing substance use disorders face barriers to treatment, including childcare, stigma and lack of gender/trauma-informed programming. Several non-government...
BACKGROUND
Women experiencing substance use disorders face barriers to treatment, including childcare, stigma and lack of gender/trauma-informed programming. Several non-government organizations in New South Wales run women-only treatment services to address these needs.
OBJECTIVES
We aim to assess characteristics of women entering treatment in these services.
DESIGN
Data on client characteristics from six women-only non-government organization substance use disorder treatment services in New South Wales between 2014 and 2018 were extracted from a database containing demographics, drug use and treatment characteristics and psychological distress (Kessler-10 scale) of women entering the services. Logistic regression models were used to estimate unadjusted odds ratio and adjusted odds ratio for treatment completion and different drugs on entry.
RESULTS
Data were available for 1357 women. Most (91%) episodes were for residential treatment. Women's mean age was 35.4 years (standard deviation = 9.8; range = 17-67). Residential clients tended to be younger than non-residential clients (35.1 vs 38.5 years, p < 0.001). Methamphetamine (43%) and alcohol (32%) were the most reported principal drug of concern. Women (89%) reported high levels of psychological distress (median Kessler-10 scale score = 27.5, range = 10-50), highest for women reporting alcohol as their principal drug. Overall, 43% of episodes resulted in treatment completion, most commonly for women entering residential treatment (45% vs 22%, p < 0.001) and for alcohol treatment (adjusted odds ratio = 1.42; confidence interval = 1.07-1.90; p < 0.001). Women with Kessler-10 scale scores indicating anxiety or depression at treatment entry were less likely to complete treatment than those with lower scores (adjusted odds ratio = 0.56; confidence interval = 0.38-0.80; p < 0.001).
CONCLUSION
Women entering women-only residential treatment tend to be younger and report methamphetamine as principal drug of concern. Women enter treatment with high degrees of psychological distress. Women's services need to ensure their programmes can respond to diverse needs of younger women presenting with methamphetamine use disorder and older women with alcohol use disorder experiencing high levels of psychological distress.
Topics: Humans; Female; Aged; Adult; New South Wales; Substance-Related Disorders; Alcoholism; Anxiety; Methamphetamine
PubMed: 37921428
DOI: 10.1177/17455057231200133 -
Addictive Behaviors Jul 2020To examine the association between cannabis use and subsequent other illicit drug use and drug use disorders (harmful use and dependence).
AIMS
To examine the association between cannabis use and subsequent other illicit drug use and drug use disorders (harmful use and dependence).
DESIGN, SETTING, PARTICIPANTS
We used survey data from a population-based cohort in Stockholm County (collected 1998-2000), with linkage to the National Patient Register. The study base comprised participants aged 20-64 years (N = 10 345), followed-up until 2014. Cox and logistic regression analyses were conducted to test associations between self-reported cannabis use and risk of subsequent other illicit drug use (three-year follow-up) and drug use disorders (16-year follow-up).
FINDINGS
The odds ratio (OR) for other illicit drug use onset at three-year follow-up for lifetime cannabis users was 7.00 (4.47-10.35, 95% CI) and for recent cannabis users 34.41 (19.14-61.88, 95% CI). Adjusting for age and AUDIT score attenuated the association, for lifetime users: OR = 5.48 (3.69-8.13, 95% CI) and OR = 5.65 (3.80-8.41, 95% CI), and for recent users: OR = 18.32 (9.88-33.99, 95% CI) and OR = 20.88 (11.19-38.95, 95% CI). For cannabis users only, the hazard ratio (HR) for drug use disorders at 16-year follow-up was 0.89 (0.31-2.61, 95%CI). For cannabis and other illicit drug users, the corresponding HR was 7.27 (3.85-13.75, 95% CI).
CONCLUSIONS
There was no independent association between cannabis use and subsequent drug use disorders. The association with subsequent drug use disorders was rather explained by other illicit drug use, which cannabis users were at higher risk of at the three-year follow-up.
Topics: Adult; Cannabis; Follow-Up Studies; Humans; Illicit Drugs; Marijuana Abuse; Middle Aged; Substance-Related Disorders; Sweden; Young Adult
PubMed: 32179379
DOI: 10.1016/j.addbeh.2020.106390 -
Social Science & Medicine (1982) Feb 2020Drug-related mortality in the US grew dramatically in recent years, while mental health deteriorated among disadvantaged Americans and reported levels of pain increased...
Drug-related mortality in the US grew dramatically in recent years, while mental health deteriorated among disadvantaged Americans and reported levels of pain increased over the same period. Here we investigate whether increased prevalence of drug misuse between the mid-1990s and early-2010s is associated with higher levels of mental distress and pain. Our results demonstrate higher drug misuse over this period, particularly for older and for socioeconomically disadvantaged Americans. After adjusting for sociodemographic characteristics, we estimate that the prevalence of drug misuse increased by 19 percentage points among those aged 50-76 in the bottom percentile of socioeconomic status (SES). Misuse increased much more at older than at younger ages for all drug types except sedatives, which increased to a similar degree in both age groups. Compared with measures of mental health, pain consistently accounted for a greater share of the period differential in drug misuse among both age groups and across all drug types. Misuse of prescription painkillers exhibited the largest difference in the contributions of pain versus mental health: among older individuals with the lowest SES, pain explained three times as much of the period trend as mental health (60% vs. 19%). Pain was more closely linked with the rise in misuse of prescription painkillers than other drugs. Mental health is a strong correlate of drug misuse (particularly sedative use), but growing drug misuse since the mid-1990s was more strongly linked with rising levels of reported pain than with deterioration in mental health. Pain could be a key factor underlying the association between trends in mental health and drug use: higher levels of pain may contribute to both mental distress and drug misuse. Given that pain, mental distress, and drug misuse are intertwined, successful intervention may require addressing all three factors.
Topics: Aged; Analgesics, Opioid; Drug Misuse; Humans; Mental Health; Middle Aged; Pain; Prescription Drug Misuse; Substance-Related Disorders; United States
PubMed: 31978637
DOI: 10.1016/j.socscimed.2020.112789 -
Tidsskrift For Den Norske Laegeforening... Jun 2021The purpose of the study was to investigate health-related help-seeking behaviour among illegal substance users.
BACKGROUND
The purpose of the study was to investigate health-related help-seeking behaviour among illegal substance users.
MATERIAL AND METHOD
Data were collected on the website Rusopplysningen.no. Questions were asked about use of illegal substances and openness with healthcare personnel regarding this use. Only respondents who reported having used illegal substances were included, and missing responses to particular questions were excluded from the percentage calculations.
RESULTS
Altogether 2 485 respondents had used illegal substances. A total of 880 (39 %) had told healthcare/social care personnel about their substance use, of which 506 (68 %) reported that they had no need of help. Altogether 802 (36 %) had avoided telling healthcare/social care personnel about their use of illegal substances in relevant situations, while 309 (14 %) believed that they needed treatment for substance use, and 202 of these (65 %) had avoided or postponed seeking such treatment. Among the 815 who had been in an acute medical situation related to substance use, 82 (10 %) had delayed calling an ambulance, and 330 (41 %) had avoided calling an ambulance altogether. Among these, fear of being reported to the police was the most frequently reported reason (n = 280, 71 %), while 216 (55 %) reported that they had considered an ambulance to be unnecessary.
INTERPRETATION
Many users of illegal substances do not reveal this to healthcare personnel. Some also avoid calling an ambulance in acute substance-related situations. Fear of police sanctions appears to be a plausible contributory factor.
Topics: Drug Users; Help-Seeking Behavior; Humans; Illicit Drugs; Substance-Related Disorders; Surveys and Questionnaires
PubMed: 34107659
DOI: 10.4045/tidsskr.21.0249 -
PloS One 2023Early intervention alcohol and drug (AOD) programs for disadvantaged young people have the potential to substantially decrease the need for future intervention, however...
BACKGROUND
Early intervention alcohol and drug (AOD) programs for disadvantaged young people have the potential to substantially decrease the need for future intervention, however there is little research about how young people use these programs or the substance use and other outcomes of such programs. This paper uses data from an Australian AOD early intervention program, The Street Universities, to: describe young people's participation; examine changes in substance use and wellbeing over 90 days; and assess which young people are most positively impacted.
METHODS
Data come from a prospective study of new attendees, measuring retention in and attendance patterns in an 'engagement' program focussed on arts and lifestyle activities (n = 95), and a routine service dataset collected from seven years of therapeutic intervention (n = 3,893), measuring substance dependence (SDS), psychological distress (K10) and quality of life (EQoL).
RESULTS
Analysis reveals that young people were retained in the program at high proportion (63% at six months) and more than half of these returned at a frequency of weekly or more often. Young people participating in the therapeutic component of the program reported significant improvements in all key wellbeing indicators with SDS, K10 and EQoL scores significantly improving (at p < .001). These improvements occurred rapidly, within the first 30 days, and were maintained over the 90 day study period. Moreover, young people with the highest SDS and K10 scores and lowest quality of life at baseline experienced the most positive changes.
CONCLUSION
Aligning engagement program with therapeutic intervention can provide comprehensive support to disadvantaged young people, producing substantial improvements in AOD use, distress and wellbeing.
Topics: Humans; Adolescent; Quality of Life; Universities; Prospective Studies; Australia; Substance-Related Disorders
PubMed: 37200391
DOI: 10.1371/journal.pone.0286025 -
European Journal of Public Health Apr 2023Since the appearance of zolpidem on the market, the occurrence of serious cases of abuse, misuse and dependence have come to the attention of authorities. In view of the...
BACKGROUND
Since the appearance of zolpidem on the market, the occurrence of serious cases of abuse, misuse and dependence have come to the attention of authorities. In view of the increase in the number and severity of cases among zolpidem users and the predominant presence of zolpidem in falsified prescriptions, the French Health Authorities implemented part of the narcotics regulation for zolpidem in April 2017. The objective of this article was to describe the evolution of the abuse, dependence and misuse of zolpidem.
METHODS
We used three data sources: (i) zolpidem is a reimbursable and strictly prescription drug in France. Medic'AM is a public database that indicates the number of tablets reimbursed each month in France for each reimbursable drug. This database has been analyzed as a proxy of the exposure of the French population to zolpidem; (ii) all French cases of drug dependence or abuse reported by health professionals (regulatory obligation) and (iii) an epidemiological tool based on the surveillance of falsified prescriptions over two periods: the 3-year period before the regulatory measure (2014-16) and the 3-year period after the regulatory measure (2018-20).
RESULTS
This regulatory change had two immediate consequences: a sharp decline in falsified prescriptions and a decrease of ∼57% between the two study periods in the zolpidem reimbursement data. Markers of problematic consumption remained after the regulatory change with worsening cases, particularly for people who were genuinely dependent and/or had comorbidities or misusers for whom zolpidem was the substance of interest, whose proportion increased significantly in the addictovigilance notification system, from 43.6% (N = 107) to 59.3% (N = 127) (P < 0.01).
CONCLUSIONS
Further monitoring is needed in light of these persistent markers of problematic consumption.
Topics: Humans; Zolpidem; Follow-Up Studies; Substance-Related Disorders; Prescriptions; France; Hypnotics and Sedatives
PubMed: 36749030
DOI: 10.1093/eurpub/ckad003 -
Pharmacological Research Apr 2024Substance use disorders (SUD) are chronic relapsing disorders governed by continually shifting cycles of positive drug reward experiences and drug withdrawal-induced... (Review)
Review
Substance use disorders (SUD) are chronic relapsing disorders governed by continually shifting cycles of positive drug reward experiences and drug withdrawal-induced negative experiences. A large body of research points to plasticity within systems regulating emotional, motivational, and cognitive processes as drivers of continued compulsive pursuit and consumption of substances despite negative consequences. This plasticity is observed at all levels of analysis from molecules to networks, providing multiple avenues for intervention in SUD. The cytoskeleton and its regulatory proteins within neurons and glia are fundamental to the structural and functional integrity of brain processes and are potentially the major drivers of the morphological and behavioral plasticity associated with substance use. In this review, we discuss preclinical studies that provide support for targeting the brain cytoskeleton as a therapeutic approach to SUD. We focus on the interplay between actin cytoskeleton dynamics and exposure to cocaine, methamphetamine, alcohol, opioids, and nicotine and highlight preclinical studies pointing to a wide range of potential therapeutic targets, such as nonmuscle myosin II, Rac1, cofilin, prosapip 1, and drebrin. These studies broaden our understanding of substance-induced plasticity driving behaviors associated with SUD and provide new research directions for the development of SUD therapeutics.
Topics: Humans; Substance-Related Disorders; Cytoskeleton; Actin Cytoskeleton; Brain; Substance Withdrawal Syndrome
PubMed: 38499081
DOI: 10.1016/j.phrs.2024.107143 -
Regulatory Toxicology and Pharmacology... Dec 2021Lemborexant is a dual orexin receptor antagonist (DORA) approved in multiple countries including the United States, Japan, Canada and Australia for the treatment of...
Lemborexant is a dual orexin receptor antagonist (DORA) approved in multiple countries including the United States, Japan, Canada and Australia for the treatment of adults with insomnia. As required for marketing approval of new compounds with central nervous system activity with sedating effects, the abuse potential of lemborexant was assessed in accordance with regulatory guidelines, which included three nonclinical studies. These assessments comprised physical dependence and drug discrimination studies in rats and a self-administration study in rhesus monkeys. There was no evidence of withdrawal signs following abrupt drug discontinuation, indicating that lemborexant does not induce physical dependence. In the drug discrimination study, lemborexant at doses up to 1000 mg/kg administered orally did not cross-generalize to the zolpidem training stimulus, although another DORA included in the same experiment, suvorexant, showed partial generalization with zolpidem. In rhesus monkeys, lemborexant treatment did not induce any gross behavioral changes, and there was no increase in self-administration rates compared with control, indicative of a lack of reinforcing effects of lemborexant. Collectively, these nonclinical studies support the position that lemborexant, which has been placed in Schedule IV by the United States Drug Enforcement Administration, has a low risk of abuse in humans.
Topics: Animals; Dose-Response Relationship, Drug; Female; Hypnotics and Sedatives; Male; Orexin Receptor Antagonists; Pyridines; Pyrimidines; Rats; Substance Withdrawal Syndrome; Substance-Related Disorders
PubMed: 34619288
DOI: 10.1016/j.yrtph.2021.105053 -
Substance Abuse Treatment, Prevention,... Jan 2021Consuming drugs in conjunction with sexual intercourse may shape the perceived interdependence of drug use and sexual intercourse (PIDS). Additionally, the severity of...
The relationship between severity of drug problems and perceived interdependence of drug use and sexual intercourse among adult males in drug addiction rehabilitation centers in Japan.
BACKGROUND
Consuming drugs in conjunction with sexual intercourse may shape the perceived interdependence of drug use and sexual intercourse (PIDS). Additionally, the severity of drug problems may have a significant impact on PIDS. However, this relationship remains unverified. Therefore, this study investigates whether the severity of drug problems is associated with PIDS among adult males in drug addiction rehabilitation centers (DARC) in Japan.
METHODS
This study was a secondary analysis of the "DARC Follow-Up Study in Japan" conducted by the National Center of Neurology and Psychiatry in 2016, in which participants from 46 facilities completed a self-report questionnaire. A total of 440 males with drug dependence were included in the analysis. We analyzed participants' demographic characteristics, history of sexually transmitted disease diagnoses, and responses to questions related to drug use (e.g., primary drug use and PIDS). Additionally, we measured the severity of drug problems using the Japanese version of the Drug Abuse Screening Test-20 (DAST-20).
RESULTS
The median age of the participants was 42 years. The median DAST-20 score was 14.0, the primary drug was methamphetamine (61.4%) and new psychoactive substances (NPS: 13.6%). Multivariate analysis indicated that participants' experiences with unprotected sexual intercourse ("mostly a non-condom user": adjusted odds ratio (AOR) = 4.410), methamphetamine use (AOR = 3.220), new psychoactive substances use (AOR = 2.744), and the DAST-20 score (AOR = 1.093) were associated with PIDS.
CONCLUSIONS
This study indicated that the frequency of unprotected sexual intercourse under the influence of drugs, methamphetamine and NPS use were strongly associated with PIDS. The severity of drug problems was also significantly associated with PIDS. It is necessary to develop culturally appropriate treatment programs adapted to the needs of patients who experience strong PIDS.
Topics: Adult; Coitus; Follow-Up Studies; Humans; Japan; Male; Pharmaceutical Preparations; Substance Abuse Treatment Centers; Substance-Related Disorders
PubMed: 33413509
DOI: 10.1186/s13011-020-00339-6 -
The American Journal on Addictions May 2023Asian American Pacific Islanders (AAPIs) face unique barriers in seeking treatment for substance use disorders (SUD) and are less likely than the general population to... (Comparative Study)
Comparative Study Review
BACKGROUND AND OBJECTIVES
Asian American Pacific Islanders (AAPIs) face unique barriers in seeking treatment for substance use disorders (SUD) and are less likely than the general population to receive treatment. Barriers specific to AAPI women may be especially significant given identified gender and racial differences in SUD prevalence and treatment. This review examines rates of SUD in AAPI women and summarizes the literature on SUD treatment for AAPI women.
METHODS
Data from 2016 to 2019 National Survey on Drug Use and Health (NSDUH) surveys were extracted to summarize rates of SUD. A scoping review of the literature on AAPI women and SUD treatment was conducted; eight articles published from 2010 to present were reviewed.
RESULTS
The prevalence of SUDs among AAPI women increased overall, although rates of SUDs were generally lower in AAPI women compared to their male counterparts. Patterns of gender differences in SUDs varied for subpopulations of AAPI women. There is limited research on treatment utilization and access for AAPI women. The few studies that examined treatment outcomes found favorable outcomes for AAPI women; research on culturally adapted interventions was promising but nascent.
DISCUSSION AND CONCLUSIONS
Literature on SUD treatment for AAPI women is limited. The availability of more culturally tailored treatments addressing the specific needs of AAPI women may lead to more acceptability and treatment utilization for this group. Additional research is needed to elucidate the unique barriers to treatment AAPI women face.
SCIENTIFIC SIGNIFICANCE
With rising rates of substance use in AAPI women, there is a need to develop and test effective SUD treatments adapted for AAPI women.
Topics: Female; Humans; Male; Asian; Health Surveys; Native Hawaiian or Other Pacific Islander; Pacific Island People; Substance-Related Disorders; Asian American Native Hawaiian and Pacific Islander; Prevalence; Sex Factors
PubMed: 36573305
DOI: 10.1111/ajad.13372